Lancaster Catholic Parochial Wrestling

CRUSADER MAT CLUB

Registration to be held at LCHS Wrestling Room on October 28, 2008 between 6:30 PM & 8:00 PM

or send to

Steve Bomberger 431 N. President Ave Lancaster, PA 17603 (717) 399-3579

Please fill out the information on this form for our records. Please print neatly or type.

Name:

Date:

Address:

City:

Zip Code:

Phone:

School:

Grade

Parent/Guardian's Names:

Birth Date

Emergency Contact (Other than parent or guardian):

Emergency Contact Phone:

E-Mail Address

Any Medical Conditions:

T-Shirt Size:

Practices: Tuesdays & Thursdays 6:30 PM - 8:00 PM from November 25 to February 19

Parents Meeting to be held November 25, during 1st practice

Please include Registration Fee of $40.00

Payable to: Lancaster Catholic Parochial Wrestling

Membership Rules:

Members shall work to the best of their ability.

Members shall be attentive to instruction and non-disruptive to other members.

Members shall treat other members and coaches with respect.

Members shall not deface any of the facilities and shall treat all equipment with care.

Members are free to attend any or all sessions but are encouraged to attend as many as possible.

Any members who persist with repeated discipline problems will be dismissed

I agree to abide by the rules and guidelines laid out above, and understand that failure to do so may result

in my dismissal from the program. By my signature I certify that I have read the rules and agree to abide by them.

CLUB MEMBER SIGNATURE:

Liability Release

I, the undersigned, individually and as a parent/guardian of

, a minor, ask

that he/she be admitted to participate in the Parochial Wrestling Program. I do hereby agree to release, discharge and

hold harmless Lancaster Catholic High School, the Crusader Mat Club, any and all coaches and employees connected

with the program, of all causes, liabilities, damages, claims or demands whatsoever on account of any injury or accident

involving the said minor arising out of the minor's attending the club or in the course of competition and/or activities held

in connection with the club.

PARENT/GUARDIAN SIGNATURE REQUIRED:

Parent Volunteers Needed for the following, if interested please check

Coaching (no experience necessary)

Treasurer (preferably an accountant to manage our account)

Secretary (person or couple to keep track of tournament entrants)

Parental Support (as needed)